SANT LONGOWAL INSTITUTE OF ENGINEERING & TECHNOLOGY,

(DEEMED-TO-BE-UNIVERSITY)
LONGOWAL-148106, DISTT. SANGRUR, PUNJAB
(ESTD. BY GOVT. OF INDIA)

FORM OF APPLICATION FOR GROUP “A” POSTS

(For use of candidates)
Affix Passport size
Name of the Post applied__________________________________________ Attested Photograph
Department ______________________________________________
Advertisement No. _________________________________________

01. Name in Full (Block Letters)

02. Fathers Name

03. Date of Birth Place of Birth

04. Marital status Sex (Male/Female)

05. Nationality

06. Permanent address Address for Correspondence

07 Telephone Number

Mobile number

E-mail Id

PAN Card No.

UID No.

08. Please, state whether you belong to

SC/ST/OBC/Physically Handicapped/
Gen category (enclose relevant
certificate)
09. Are you willing to accept the minimum
initial pay offered, if not, state what is
the lowest initial pay that you would
accept
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10. Present Post held with Designation &

name of the Organization where
employed
Name of the Post Held Nature of Duration
Organization Duties/work From To

11. Present salary with pay scale

Pay Scale Basic Pay D.A. H.R.A. Any Other Total Rs.
Allowances

12.a. Were you at any time declared

medically unfit, asked to submit your
resignation, discharged or dismissed
from Government or private service?

b. Have you ever been convicted by any

court of law or is there any criminal
case/ disciplinary enquiry
contemplated or pending against you?
If yes, please give details.

13. Details of educational qualifications: Please give particulars of all examinations passed and
degrees obtained commencing with the High School Level (10th standard / Matriculation)
Examination. Please attach photocopies of certificates and mark sheets duly attested.
Examination School / Name of Marks % of Distinction/ Year of Duration of
College / the Obtained marks Class / Passing course
Institute Board/ (with Max. Division/
Universit Marks) /Grade
y/
Institutio
n
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14. Details of employments: Please give particulars of your present and past employments in chronological order, starting with
the present one:

Sl. Organization Position Nature of Date of Date of Experience Last Scale of

No. / Institute held duties / joining leaving (Years & Pay pay/Pay
work months) Band &
GP

15. Membership of Professional Bodies/Societies (Please specify National/International)

16. Extra-curricular Activities/Administrative Responsibilities handled :-

17. Vision of Reforms in the Institute (Not more than 200 words):-

18. Any other information in favour of the candidature of the Application (Attach separate sheet, if
required).

19. References: (At least two names of referees with their clear and complete addresses along
with e-mail Id. Referees should be persons with or under whom the candidate has worked and
one of the referees should be from the last Organization/Institute served. Referee should not
be close relative of the candidate).

1. _________________________________________ 2. ____________________________________

_________________________________________ ____________________________________

_________________________________________ _____________________________________

20. Check List (item-wise) documents attached.

(a) _______________________________ (b) _________________________________

(c) ______________________________ (d) __________________________________

(e) ______________________________ (f) __________________________________

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21. Detail of Demand Draft :-

(a) DD. No. & Date_______________ (b) Amount______________ (c) payable at _______________.

Declaration : I solemnly declare that :

I. All the statements and entries made in this application are true, complete and correct to the
best of my knowledge and belief. In the event of any information being found false or incorrect
or ineligibility being detected before or after the Selection Committee or at any other stage, my
candidature/ appointment may be cancelled by the SLIET, Longowal without prejudice to
initiation of any other disciplinary action.
II. I have never been disqualified from University work/appearing in any University examination.
III. I have never been dismissed either from Govt. or from University, college or other Public or
Private Organization service.
IV. I have never been prosecuted, kept under detention or bound down/fined, convicted by the
Court of Law for any offence.

Place : ___________________
_________________________
SIGNATURE OF APPLICANT
Dated : __________________

Endorsement by the EMPLOYER

In case of in-service candidates in Government / Semi-Government organizations / Public Sector

Undertakings / Autonomous Organizations, the endorsement form must be signed by the employer.

The applicant Dr./Mr./Mrs/Ms.____________________________________________, who has submitted this

application for the post of __________________________ in the Sant Longowal Institute of Engineering and
Technology, Longowal, Distt. Sangrur has been working in this organization
namely_______________________ in the post of ______________________ in a temporary / contract/ permanent
capacity w.e.f. ________________ in the Scale of Pay of Rs.____________________, with AGP of Rs.________ .
There is no objection for his/her application being considered by the Sant Longowal Institute of
Engineering and Technology, Longowal, Distt. Sangrur.

(Signature of the forwarding officer)

Name: __________________________

Designation: __________________________

Place: __________________________

Seal Date : __________________________